Broken health systems broke healthcare workers, not COVID-19

This article was exclusively written for The European Sting by Mr. Alexander Chu, a fourth-year medical student at Dell Medical School at the University of Texas at Austin. He is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Rounding the corner on the hospital fourth floor, I found myself in a long corridor lined with red warning messages plastered to the door of each patient room – “PPE REQUIRED WHEN ENTERING.” It was January 2021, and the highly-transmissible Omicron variant was spreading like wildfire throughout Central Texas. Starting my internal medicine rotation, I was excited about participating in and learning from inpatient care. However, for the next two months, I did not expect to witness the exhaustion and sheer burden of demands placed onto the physicians, nurses, pharmacists, and social workers I worked with. Some had to work while sick, while others had to work additional shifts to cover short-staffed teams. I knew deep down that they all truly cared about their patients, but their jadedness often masked the ability to express their innate, human desire for caregiving.

My experience is not an isolated example. During this past year, I have met and learned from numerous Peruvian, Mexican, Taiwanese, and British healthcare workers who have all confessed to experiencing some degree of worsening “burnout” – a pervasive issue that had already been culminating well before the pandemic. Recent figures in the US indicate that over 60% of physicians experienced some form of burnout in 2021 and had significantly decreased work-life satisfaction in comparison to pre-pandemic years. An estimated 334,000 healthcare providers left the US workforce while only a fraction joined it in 2021. The pandemic stretched the limits of health systems around the world, and it laid ruin to an already demoralized, exhausted, and often unsupported workforce in that process. The pandemic did not “break” the workforce. Health systems that were already broken did.   

Although the World Health Organization recently ended its COVID-19 emergency declaration, the physical, mental, and emotional trauma and scars of the pandemic on healthcare workers are long from over. Healthcare workers in many countries are collectively voicing their dissatisfaction about the broken ecosystems in which they work in. In the US, unionization efforts among resident physicians at numerous major hospital groups have been underway and gaining traction, representing a major shift in the way that US physicians have organized themselves and voiced their positions on structural issues related to patient care. This is the case even in countries with universal healthcare. The British Medical Association and Royal College of Nursing have been embroiled in disputes with the UK government on efforts to negotiate better pay and working conditions, taking industrial action on several recent occasions. 

The time for change has been long overdue. The “post-pandemic” period represents a window to reimage and catalyze action toward creating health systems that provide equitable access and care for all patients and that provides healthcare workers with adequate pay, safe working conditions, and respect. However, the calls for change by healthcare workers will not be enough. They also need the collective support of citizens and voters, community leaders, healthcare administrators, and policymakers to actualize the vision in which reimaged health systems value the wellbeing of healthcare workers as priorities.

About the author

Alexander Chu is a fourth-year medical student at Dell Medical School at the University of Texas at Austin and is committed to promoting global health equity and social justice through clinical medicine, research, and policy & advocacy. His global health and clinical work have been primarily focused in Latin America (Perú and México) as well as in Latin American immigrant populations living in Central Texas. He is particularly interested in the epidemiology of tuberculosis and emerging infectious diseases, the biosocial intersection between mental health and tuberculosis, and community-centered models and strategies for improving global health delivery and health systems strengthening.